Individual
BERNARD RADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
721571
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069945
BLUE CROSS
IL
01
—
069945X05850151548
SMED SUPP PLANT
IL
Enumeration date
04/11/2007
Last updated
07/08/2007
Update your record
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